Steps to Become a Radiologist

Written by Brit Haines

If you’re a radiology tech, also known as a radiographer, becoming a radiologist can help you advance your career and earn higher wages. Read on to learn how you can become a radiologist and what a radiology degree can do for you.

What’s the Difference Between a Radiologist and a Radiographer (Radiology Tech)?

Whether you are already a radiographer or are new to the field, you may wonder what the difference is between a radiologist and a radiographer. The main difference comes down to the job’s function and required education. For example, where a radiology tech takes X-rays, a radiologist reads the results.

Radiographers perform the diagnostic imaging examinations on patients and operate technology, such as MRIs, while preparing patients for medical procedures and following the physician’s instructions on what parts of the body needs imaging. Technologists may also specialize and become certified in a certain area, such as mammograms.

Radiologists, on the other hand, are physicians who use imaging to diagnose and treat patients. They’re trained to interpret X-rays, MRIs, and CT scans, as well as to perform procedures like biopsies. They often specialize in a field and may obtain multiple subspecialties.

Because radiologists are more qualified than radiographers, they’re also required to graduate from medical school and gain state licensure. If you want to become a radiologist, you’ll need to complete an undergrad degree, four years of medical school, a radiology internship and residency in your specialty, and a 1-2-year fellowship program. Both radiographers and radiologists are required to become licensed by their state and/or board certified, with most employers requiring board certification.

	Radiography	Radiology
Length of Education	2 years ( 8 years minimum (4-year bachelor’s degree, plus 4 years of medical school)
Cost of Education	Associate programs in radiography are commonly priced at community colleges for around $12,000 for two years.	On average, bachelor’s degrees cost $25,000, while public med schools average around $207,866.
Licensing Requirements	Some states require licensure, but most employers require technologists to become certified.	Radiologists must pass the US Medical Licensing Exam and obtain licensure and board certification to practice in each state.
Salary	$61,240 per year	$208,000 per year
Job Description	A healthcare professional who prepares patients for and conducts imaging scans, using scanning equipment.	A doctor who specializes in using medical imaging technology, such as an X-ray, MRI, or CT scan to diagnose and treat a variety of conditions.

What Does a Radiologist Do?

A radiologist, like most doctors, diagnoses and treats patients. Technologists run the medical imaging tests, but radiologists direct them through the process, read the test results, and treat diseases using radiation or therapeutic intervention. Practicing radiologists also specialize in an area such as:

• Diagnostic radiology
• Interventional radiology
• Radiation oncology

There are also several subspecialties in which radiologists can earn board certification. Keep these in mind as you pursue your radiology education, as different specialties affect the scope of your daily duties.

Diagnostic Radiology

In diagnostic radiology, you’ll use X-rays, ultrasounds, radionuclides, and electromagnetic radiation. This specialty requires a year of clinical training, four years of radiology training, and a fellowship. If you want to subspecialize, you’ll also need to earn a certification in diagnostic radiology.

Subspecialties:

• Hospice and palliative medicine – Relieve the suffering of patients with a terminal diagnosis
• Pain medicine – Care for patients with acute and/or chronic pain
• Neuroradiology – Help patients with brain, spine, sinus, neck, or central nervous system disorders
• Pediatric radiology – Treat infants and young patients with congenital abnormalities or childhood diseases
• Nuclear radiology – Administer radioactive substances to make a diagnosis, often using PET and SPECT scans
• Vascular and interventional radiology – Use technology like MRIs, sonography, CT scans, and other therapies to treat patients

Interventional/Diagnostic Radiology

Interventional radiologists use minimally invasive procedures to diagnose and treat patients with either malignant or benign conditions in the pelvis, abdomen, thorax, or extremities. Training typically includes three years of diagnostic radiology, as well as two years of interventional study and certification in the area.

Subspecialties:

• Hospice and palliative medicine
• Pain medicine
• Neuroradiology
• Pediatric radiology
• Nuclear radiology

Radiation Oncology

In this role, you’ll use ionizing radiation to treat malignant diseases. You may also handle some benign diseases and use technology like CT scans, MRIs, ultrasounds, or hyperthermia treatments. Training for this specialty requires a year of clinical study and four years in radiation oncology.

Subspecialties:

• Hospice and palliative medicine
• Pain medicine

How to Become a Radiologist

If you’re a radiology tech looking to become a radiologist, follow these steps:

1. Earn a bachelor’s degree – Most take four years to complete. If you have an associate degree already, earning a bachelor’s typically takes only two years for full-time students.
2. Complete medical school – Get accepted into an M.D. or D.O. medical program and pass the United States Medical Licensing Examinations (USMLE) during your final year.
3. Complete a residency – Apply to a four-year post-graduate residency program in your specialty. During your first year (the intern year) you will gain hands-on training. In the end, you must pass a series of exams.
4. Join a fellowship – Apply for a one or two-year fellowship program if you want to pursue a subspecialty in radiology.
5. Obtain certification and licensure – All physicians must obtain state licensure in their specialty to practice. Most (not all) employers also seek board certification, which involves a two-part exam. State requirements will vary, and some states consider certification to double as licensing.

Radiology Degrees

Bachelor’s Degrees in Radiology

Before you can get into med school you need to earn a bachelor’s degree. They often take four years to complete, or possibly as little as two years if you’re already working as a radiology tech and have an associate degree. Because most schools don’t offer a radiology degree at the bachelor’s level, you should select a major that involves med school prerequisite courses to better prepare you, such as biology, chemistry, or physics. Expect your undergrad curriculum to include courses like:

• Anatomy and physiology
• Pathology
• Radiology physics
• Biology
• Chemistry
• Organic chemistry
• Physics

If you’ve already completed an associate degree in radiology, you may receive credit for the core courses you’ve completed such as English, history, biology, chemistry, or math.

You’ll also need to take the Medical College Admissions Test (MCAT) as part of your med school application. Most students begin applying during their junior year as an undergrad, so you’ll need to take the MCAT before then.

Medical School

All physicians must go to medical school, which takes four years to complete. The application process for med school takes about a year to complete. You’ll need to fill out an application, submit letters of recommendation, submit your MCAT score, and interview with faculty heads.

Select either an allopathic (M.D. degree) or osteopathic (D.O. degree) type of medical school, depending on which philosophy you prefer. Allopathic schools focus on diagnosing and treating patients using medication or surgery, while osteopathic schools focus on prevention. Either type of program will allow you to become a radiologist and select a subspecialty.

The courses you take will depend on the radiology specialty you choose. Your coursework will involve both classroom lecture and instruction in clinical settings, where you’ll learn how to treat patients. During the first two years, expect to take advanced courses in anatomy and physiology, biochemistry, microbiology, pharmacology, and human behavior.

You will spend the last two years of your medical program completing clinical rotations in various specialties, where you’ll learn hands-on training from experienced physicians in a hospital or doctor’s office. During clinicals, students rotate through the major specialties along with some radiology specialties. Use this time to figure out what specialty, if any, may interest you.

After Graduation

After you graduate from med school you can apply for your medical license, select a specialty, and find the right radiology residency for you. Here are the steps you’ll take before you can find a job:

1. Complete an internship – Your first year as a resident is known as your intern year, where you will practice general medicine under supervision.
2. Select a specialty and complete residency – Once you decide on a specialty, you’ll spend four years training in this area. Most residency programs require an internship during the first year followed by three years of hands-on training in your specialty.
3. Join a fellowship – If you want to subspecialize, you’ll also need to complete at least a year-long fellowship in the area of the specialty. Some radiologists subspecialize in more than one area.
4. Earn licensure – Obtain licensure by passing the USMLE. State requirements may vary.
5. Become board certified – Pass a two-part exam to earn board certification through the American Board of Radiology, which most employers will seek in job candidates. Subspecialties come with additional requirements.

How Much Does a Radiologist Make?

Compared to the $61,240 per year radiographers earn, radiologists earn higher salaries. According to the United States Bureau of Labor Statistics (BLS), the average salary of a physician, which includes radiologists, is $208,000 per year. Physician careers are expected to grow at 13%, which is faster than the national average for all jobs.

Employment is especially good in states with large populations or higher need for qualified physicians. The states with the highest employment, according to the BLS, include:

• New York
• California
• Texas
• Florida
• Pennsylvania

Radiologists in certain states also earn higher salaries. The top five states with the highest wages include:

• New Hampshire
• North Dakota
• Maine
• Montana
• Minnesota

Pros and Cons of Becoming a Radiologist

If you choose to go back to school to become a radiologist, you may earn a much higher salary and find a better career. As a radiologist, you can specialize in an area of radiology that interests you and treat the patients you care about. It’s a rewarding position all around. The hours are often flexible, and the need for radiologists is increasing.

However, you must complete a bachelor’s degree if you haven’t already, as well as attend medical school. Your education will take years (or even a decade!) of hard work. Also, tuition isn’t cheap. Even though you earn more money as a radiologist than as a radiographer, you could have hundreds of thousands of dollars of student loans if you can’t pay for your education up front. Expect some sacrifices on your path to becoming a radiologist.

Brit Haines graduated from the University of Missouri-Kansas City with a degree in English. Although, she nearly wound up with a degree in teaching. She has worked as a freelance writer for over three years. In that time, she’s written many articles on higher education. She’s also tutored children in spelling and vocabulary, taught enrichment classes, and volunteered at local elementary schools.